Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $971.62 / $971.62 / $971.62	Facility		$971.62	$971.62	$971.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $680.90 / $971.62 / $1,613.25	Professional		$680.90	$971.62	$1,613.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,926.05 / $2,118.66 / $3,505.41	Facility		$1,926.05	$2,118.66	$3,505.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,665.84 / $1,791.23 / $2,369.04	Professional		$1,665.84	$1,791.23	$2,369.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,385.59 / $4,121.75 / $4,121.75	Facility		$1,385.59	$4,121.75	$4,121.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $902.63 / $3,982.15 / $8,039.10	Facility		$902.63	$3,982.15	$8,039.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $658.92 / $2,790.94 / $3,645.20	Professional		$658.92	$2,790.94	$3,645.20
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $465.25 / $1,457.43 / $2,214.96	Facility		$465.25	$1,457.43	$2,214.96
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $1,102.82 / $1,904.56 / $2,311.26	Professional		$1,102.82	$1,904.56	$2,311.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $805.37 / $1,917.79 / $7,563.25	Facility		$805.37	$1,917.79	$7,563.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $810.53 / $1,085.82 / $2,097.23	Professional		$810.53	$1,085.82	$2,097.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $974.85	Professional		$50.00	$70.00	$974.85
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $465.25 / $1,457.43 / $2,214.96	Facility		$465.25	$1,457.43	$2,214.96
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $1,102.82 / $1,904.56 / $2,311.26	Professional		$1,102.82	$1,904.56	$2,311.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $1,926.05 / $2,889.08 / $4,323.93	Professional		$1,926.05	$2,889.08	$4,323.93
Quartz Facility/Professional Facility Modifier Low / Median / High Price $902.63 / $3,761.82 / $7,563.25	Facility		$902.63	$3,761.82	$7,563.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $658.92 / $902.63 / $9,141.89	Professional		$658.92	$902.63	$9,141.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,926.05 / $1,926.05 / $1,926.05	Professional		$1,926.05	$1,926.05	$1,926.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $1,926.05 / $1,926.05 / $1,926.05	Professional		$1,926.05	$1,926.05	$1,926.05
United Facility/Professional Professional Modifier Low / Median / High Price $651.35 / $1,085.58 / $1,926.05	Professional		$651.35	$1,085.58	$1,926.05